First-party collections, as software
The patient balances every provider gives up on, recovered in the provider’s own name.
DueWell works the 60-to-180-day window of patient receivables — after the first statements, before the collection agency — and is paid only on the aged dollars it recovers.
- Provider nets
- ≈30¢
- per aged $
- Agency nets you
- 10–16¢
- per aged $
- Fee basis
- 6%
- of aged $ recovered
In 70 seconds
What DueWell does, in one sitting.
The hand-off, the alternative, the patient’s side of it, what one practice measured a year later, and how the fee works. Narrated, captioned, no sales call required.
Every provider bills patients. Almost none of them are set up to collect from patients.
Deductibles moved the bill onto the patient. The provider’s tool stack never caught up — so the balance ages, and then it’s handed away.
Sources: KFF / Peterson-KFF Health System Tracker (medical debt owed); CFPB, Medical Debt Burden in the United States (debt in collections); Kodiak Solutions Benchmarking Intelligence, March 2026 (revenue loss, patient share, collection rate; hospital and health-system data); MGMA DataDive (receivables over 120 days); HFMA benchmarks. Collectability-by-age figures are RCM trade rules of thumb.
What changes when the provider keeps the account.
After day 60, a practice has two choices: hand the balance to a stranger, or keep working it as itself. Only one of these was ever available as software.
| Dimension | DueWell — first-party | Collection agency — third-party |
|---|---|---|
| Who the patient hears from | Their doctor’s office. Same name, same number, same tone as the visit. | A stranger. A different company name on the letter and caller ID. |
| When it starts | Day 60, while the balance is still fresh and the patient still remembers the visit. | Day 90–180, after the account has already gone cold. |
| What it collects | Roughly 30–60% of aged dollars, bucket-dependent, within 90–180 days. | ~17–21% of placed medical debt, over the life of the placement. |
| What it costs | Platform fee + 6% of what’s actually recovered on aged accounts. | 25–40% of whatever it recovers. |
| The provider nets | About 30 cents per aged dollar placed. | 10–16 cents per aged dollar placed. |
| Leverage | Convenience — text-to-pay, plans, card-on-file, a portal — and the relationship. | Historically, the threat of a credit report. That lever is largely gone. |
| The relationship | Intact. The patient paid the practice. | Damaged. The patient was sent to collections by the practice. |
Performance figures are single-site results from a founder-affiliated diagnostic imaging practice; observational data, no control group. Agency benchmarks: ACA International recovery data as reproduced in trade sources; contingency ranges are industry-standard.
What changed when one practice switched from its prior vendor.
March–August 2026 on DueWell against the same six months a year earlier on the vendor it replaced — same practice, same cash-event rules applied to both ledgers.
Patient cash per month
View as table
| Month | Prior vendor 2025 | DueWell 2026 | Paying patients 2025 | Paying patients 2026 |
|---|---|---|---|---|
| Mar | $93,451 | $168,404 | 597 | 931 |
| Apr | $96,185 | $157,017 | 618 | 932 |
| May | $77,112 | $136,834 | 556 | 777 |
| Jun | $71,204 | $134,514 | 487 | 821 |
| Jul | $76,511 | $131,698 | 532 | 854 |
| Aug | $67,786 | $130,669 | 522 | 777 |
| Six months | $482,249 | $859,136 | 3,312 | 5,092 |
Recovery by age of balance, both platforms
View as table
| Age at engagement | Prior vendor | DueWell | Difference |
|---|---|---|---|
| 31–60 days | 55.2% | 81.3% | 26.1 pts |
| 61–90 days | 47.6% | 62.8% | 15.2 pts |
| 91–120 days | 26.8% | 46.9% | 20.1 pts |
| 121–180 days | 30.9% | 29.3% | -1.6 pts |
Measured from the date of service, DueWell’s time to cash is longer than the prior vendor’s — it recovers balances six to twenty-four months old that the prior vendor never worked. The clock that isolates the platform is first message to cash: 15 days.
Founder-affiliated diagnostic imaging practice, single site. Platform: production ledger, read-only extraction, data as of Sep 20, 2026. Prior vendor: its raw account export through Dec 2025, recomputed under the same cash-event rules and reconciled to its published lifetime card cash ($1,135,069). The platform's days from date of service to cash are longer than the prior vendor's because it works far older balances. The cash increase cannot be separated from placement volume or deductible mix using collections data alone. Observational, no control group.
Recovery by age of balance, with method and sources →Three steps. Nothing to install, nothing to hold.
- 1
Takes the aged book
Balances 60+ days old at placement, pulled from the provider’s own billing system. Age is measured at placement — not at payment — so a slow payer never drifts into fee scope.
- 2
Works it as the provider
Text, email, and AI voice outreach that reads and sounds like the practice, not a collector. Payment plans, card-on-file, a patient portal, and consent handling that respects every stop request.
- 3
Gets paid only on recovery
A modest platform fee plus 6% of dollars recovered on aged accounts — cash actually collected, invoiced in arrears. The provider keeps 100% of what it would have collected anyway.
Payments settle to your own merchant account and bank. DueWell never holds, receives, or disburses client or patient funds. Read the full walkthrough →
First-party changes who’s speaking. It doesn’t change the rules — so we built them in.
Consent that already exists
A patient who gave the practice their number at intake consented to be contacted about that visit's balance. The provider holds that consent; an agency has to inherit it. DueWell records consent per patient, per channel, with its source and date — and contacts nobody by default.
Every stop honored, everywhere
A STOP by text, a request on a call, or a note to the front desk revokes consent across every channel at once, with an audit trail — built ahead of the FCC's 2027 revoke-all rule, not after it.
Built for the AI-voice rules
The FCC treats AI voices as “artificial” under the TCPA, and California requires disclosure. The voice agent dials only patients with explicit voice consent, says what it is, verifies date of birth before it says a balance, and never takes a card.
The doctor's office, not a debt collector
Messages come from the practice, in its name and its tone. The federal debt-collector script doesn't attach to a provider collecting its own balances — but frequency, hours, and content are held to collector standards anyway, because California applies them to creditors too.
Never on a credit report
DueWell does not furnish anything to a credit bureau. In California that is now the law; everywhere else it is what keeps the patient relationship intact.
HIPAA by design
Each client runs in its own deployment under its own BAA. Billing outreach is a permitted payment use; no patient identifiers travel to the payment processor; every access is logged.
The agency’s main leverage is gone.
In California since January 2025, reporting medical debt to a credit bureau makes the debt void. Nationally, the bureaus never report medical collections under $500 and wait a year before reporting any at all. Fifteen-plus states have their own bans.
For a typical practice balance — a few hundred dollars — the credit-report threat effectively no longer exists, and in California it is illegal to make. An agency’s remaining tools are letters and calls from a stranger, at 25–40% of recovery. First-party outreach now holds the only lever left: the relationship. The economics of the hand-off have quietly broken, and most practices haven’t re-examined the default.
Bring us the book you were about to send to collections.
A 30-minute conversation with the founder — an operator, not a rep. No slide deck, your numbers.